Lindenfeld Zoe, Cantor Jonathan H, Chang Ji E
Edward J. Bloustein School of Planning and Public Policy, Rutgers, The State University of New Jersey, New Brunswick, New Jersey.
RAND, Santa Monica, California.
J Stud Alcohol Drugs. 2025 Jul;86(4):641-650. doi: 10.15288/jsad.24-00157. Epub 2024 Oct 15.
Given that individuals with substance use disorders (SUDs) have a variety of needs beyond substance use, it is crucial to examine the comprehensiveness of services offered within outpatient SUD treatment facilities, where many individuals with SUDs receive care. This study's objective is to develop clusters of services offered and assess organizational, policy, and environmental characteristics associated with having a more comprehensive treatment model.
We conducted a principal component analysis (PCA) using data on SUD treatment facilities ( = 8,197) from the 2022 Mental Health and Addiction Treatment Tracking Repository, a national database of SUD treatment facilities. We applied a k-means cluster analysis on the generated components to cluster facilities by service offerings and calculated the mean for different organizational, policy, and environmental characteristics for each cluster.
We retained five components from the PCA, which represented the availability of different services (Pharmacotherapies, Infectious Disease and Harm Reduction, Supportive and Social Determinant of Health (SDOH) Services, Psychosocial Services, and General Health Care.) The cluster analysis resulted in five SUD service models, with the most comprehensive having the highest percentage of accredited and Medicaid-accepting facilities, and facilities that were government-operated and located in a Medicaid expansion state, and the least comprehensive having the lowest percentage of accredited, licensed, and Medicaid-accepting facilities, and the highest percentage of private, for-profit facilities.
Our study found that SUD treatment facilities varied in the availability of five treatment components, but more comprehensive service models had a higher percentage of facilities that were licensed, accredited, and accepting Medicaid.
鉴于患有物质使用障碍（SUDs）的个体除物质使用外还有各种需求，检查门诊SUD治疗设施所提供服务的全面性至关重要，许多患有SUDs的个体在这些设施接受治疗。本研究的目的是确定所提供服务的类别，并评估与拥有更全面治疗模式相关的组织、政策和环境特征。
我们使用来自2022年心理健康和成瘾治疗跟踪库（一个SUD治疗设施的全国性数据库）中关于SUD治疗设施（n = 8197）的数据进行主成分分析（PCA）。我们对生成的成分应用k均值聚类分析，以按服务提供情况对设施进行聚类，并计算每个聚类在不同组织、政策和环境特征方面的均值。
我们从主成分分析中保留了五个成分，它们代表不同服务的可及性（药物治疗、传染病与减少伤害、支持性服务和健康的社会决定因素（SDOH）服务、心理社会服务以及一般医疗保健）。聚类分析产生了五种SUD服务模式，最全面的模式中获得认证且接受医疗补助的设施比例最高，以及由政府运营且位于医疗补助扩展州的设施比例最高；最不全面的模式中获得认证、有执照且接受医疗补助的设施比例最低，以及私立营利性设施比例最高。
我们的研究发现，SUD治疗设施在五种治疗成分的可及性方面存在差异，但更全面的服务模式中获得执照、认证且接受医疗补助的设施比例更高。
